1. Field Of The Invention
The present invention relates generally to improvements in devices for supporting laparoscopes or similar surgical instruments and more particularly to support devices which will adequately secure the instrument without causing damage thereto.
2. Description Of The Prior Art
To lessen the number of personnel needed for a surgical procedure, a variety of support apparatus exists for holding instruments in the desired position to perform the procedure. For example, U.S. Pat. Nos. 4,867,404 to Harrington et al. and 4,573,452 to Greenberg disclose flexible holders for cytoscopes and laparoscopes, respectively. Additionally, U.S. Pat. No. 373,362 to Hamilton, U.S. Pat. No. 2,070,670 to Marshall and U.S. Pat. No. 3,810,462 to Szpur disclose a variety of surgical instrument support devices. The Marshall patent describes a clamp for holding a retractor having a spring 18 located on a screw 13 intermediate clamp jaws 10, 11 urging the clamp jaws apart. A handle 17 operates screw 13 to move the jaws thereby tightening or releasing the retractor. Hamilton discloses a clamp N for holding a speculum P comprising a pair of jaws which open and close by means of a tightening screw o. Spzur discloses a clamp head 28 for holding a retractor blade 26. An open space 54 is defined intermediate jaws 30, 31 to permit the blade handle 48 to pivot (FIG. 6). By tightening handle 52, the retractor blade is fixed in any desired position.
There are a number of mechanical arm devices in commercial use, which are designed to be secured to operating room tables and which fix surgical instruments or clamps for use by the surgeon. Such devices generally include one or more pivotable arms at one end and at the free end a specialized clamp, socket, tool, or instrument is provided. One such mechanical arm is described in U.S. Pat. No. 4,143,652 to Meir et al and sold under the trademark IRON INTERN.RTM. by Automated Medical Corporation of New York, N.Y. Other mechanical arms, e.g., "MARTIN ARM" are also commercially available.
Laparoscopy is a method for direct visualization of intra-abdominal organs. A laparoscope is an elongated viewing apparatus usually comprising glass fibers for transmission of light. A lens and/or television camera may be attached at the viewing end. The laparoscope is usually introduced into the abdomen via a trocar cannula. The trocar cannula disclosed in U.S. Pat. No. 4,654,030 to Moll et al. and sold under the trademark SURGIPORT.RTM. Disposable Surgical Trocar by United States Surgical Corporation of Norwalk, Conn. is representative of the type of disposable trocar cannula which may be employed with the holder of the present invention.
It is frequently necessary to remove the viewing apparatus from the abdomen in order to clean or defog the lens. When the viewing apparatus is reinserted into the abdomen via the trocar cannula, it is desirable that the precise repositioning be achieved so that the organs being examined remain in view. Otherwise, valuable time is lost when surgical personnel must reposition the laparoscope.
To permit manipulation or operation within the abdomen, one or more additional trocar cannulae may be inserted into the abdomen for the introduction of various instruments such as probes, grasping forceps, cautery devices, and the like. See, U.S. Pat. No. 4,112,932 to Chiulli for a description of laparoscopy and a laparoscopic cannula.
Laparoscopes in use today usually comprise an elongated tubular metal member. These metal tubes are usually very thin and therefore easily bent or crimped. Such bending can interfere with the viewing quality, thereby rendering the instrument permanently inoperative. Many types of trocar cannulae are similarly constructed of a thin metal. If these cannulae are bent while being held this can interfere with the passage of instruments therethrough. Alternatively, these cannulae may be made of plastic. This is to permit x-rays to pass through them, thereby permitting operative cholesystography to be performed. This plastic has insufficient strength to permit grasping for fixing in one position without deformation.
A key disadvantage of the prior art devices is that they are not suitable for securely gripping sensitive surgical instruments such as a laparoscopes, trocar cannulae, and other instruments used during laparoscopic surgery. The prior art devices often damage the instruments by exerting a clamping force which causes the walls of the instrument to buckle or bend or which damages the insulation.
Another disadvantage of the prior art devices is the fact that they are complex, bulky, and comprise a large number of interconnected or linking elements. As a result, the prior art holders are susceptible to slippage and other inadvertent movement that also interfere with the work of the surgeons and other personnel. As will be appreciated, even the slightest unwarranted movement during these surgical procedures can result in dire consequences.
Yet another disadvantage of the prior art devices is the fact that they usually must engage the laparoscope or other instrument prior to the instrument being introduced into the abdomen via the trocar cannula. This limits the manipulability of the instrument for positioning and the like. U.S. Pat. No. 4,573,452 to Greenberg is an example of one such device having this disadvantage.
Still another disadvantage of the prior art clamping devices is that they are not compatible with existing mechanical arms which are mounted to operating room tables, for holding surgical instruments in place.